JEAN KISER IS COMFORTABLE IN HER FAMILIAR SURROUNDINGS AT JOHN C. FREMONT HOSPITAL. Jean Kiser has vivid memories of her first weekend as a staff nurse at John C. Fremont Hospital. It was Labor Day weekend, 1980, and she had just completed a week of hospital orientation. Already a seasoned registered nurse with 20 years experience in surgical, obstetrics and intensive care nursing at some of Southern California’s largest and busiest medical centers, she was embarking on a brand new career as a rural hospital nurse.

She was working with Kay, a seasoned JCF nurse when a man showed up at the back door of the hospital requesting assistance for his dog. The dog had been bitten on the face by a rattlesnake. Nurse Kay quickly organized a plan of care. There was no in-hospital physician to consult in those days and so she called the local animal hospital. Dr. Rosebrock, the veterinarian, was not in his office. He was attending the fair rodeo. Eventually, he prescribed three different medications as injections, including an antibiotic and a steroid. Nurse Kay prepared the medications and administered them to the dog. Shortly thereafter, the man left the hospital with his dog. Kiser remembers thinking, “Gosh… am I going to be treating animals as well as people?”

JEAN KISER IS PICTURED WHEN SHE BEGAN HER NURSING CAREER. In 1980 there was no contracted ambulance service for Mariposa County. The ER nurse would telephone the volunteer ambulance driver (at times this might be a deputy from the sheriff’s office) and then she would telephone the on-call physician at his home and give him the details of the emergency call. Kiser remembers the ambulance as being nothing more than a van outfitted with basic first aid supplies, oxygen, intravenous fluids and a heart monitor.

Most of her calls were in response to motor vehicle accidents, cardiac events and to retrieve elderly people that had fallen and incurred hip injuries. She recalls, “I would get so carsick riding in the back of that van down Old Toll Road where it winds its way out to Hornitos.”

Kiser, while an experienced nurse, was new to emergency medicine. Dr. Evans was the most senior physician at JCF in 1980, and practiced “country medicine-type” doctoring, preferring simpler, cost-effective treatments over more complex and expensive tests when appropriate. Dr. Evans taught Kiser his method of treating head lacerations in the emergency room. Instead of sutures he tied a series of knots, using the patient’s own hair strands, to close the wound. “It was a simple and yet effective treatment that could be used in the hospital or in the field,” she said.

This week Kiser will mark her 50th anniversary as an registered nurse. She graduated from Los Angeles County General Hospital School of Nursing on Aug. 18, 1960. After completing her education she was employed by the 3,000- bed Los Angeles County General Hospital as a surgical ward nurse for a year before marrying Ronald Kiser, a member of the United States Air Force. Over the next 20 years she continued her professional nursing career while raising four children and following her husband’s military postings around the United States and abroad.

It was while Ron was stationed at Castle Air Force base in Merced, in the early 1960s that the newlyweds first became acquainted with Mariposa County and developed an interest in the history and culture of the foothill community. Kiser worked in the operating room and as an obstetrics nurse at Mercy Hospital in those early years while completing a liberal arts degree at Merced College. As a member of the California Nurses Association (CNA) she maintained a professional liaison with the registered nurses for the district that included Merced and Mariposa Counties.

In 1966, as president of that CNA group, Kiser was contacted by a Mercy Hospital physician to help organize a presentation to the local community of medical professionals. A brand new life-saving technique, developed by the American Heart Association, was being introduced for use in hospitals and medical clinics… it was called cardio-pulmonary resuscitation (CPR).

After moves to Okinawa, Japan, and Portsmouth, New Hampshire, the Kisers were transferred to Southern California where Ron would complete his 20-year military career. In 1970, Jean was recruited to work at Riverside Community Hospital in their new state of the art cardiac intensive care unit.

In 1977, Kiser took a position in the surgical intensive care unit at Loma Linda University Medical Center in San Bernardino County. Registered nurses were caring for increasingly sicker patients with more invasive lines and monitoring equipment, along with an increasing array of medications that were being developed to treat these patients. She said that nurses were assuming more responsibility and decision making at the bedside, something that had been strictly the realm of the physician in her early days of nursing.

In June of 1980, Jean wrote to the director of nurses at John C. Fremont Hospital in Mariposa seeking information on employment opportunities. By the time the Kisers arrived in Mariposa in the late summer of 1980, the director of nurses had changed but the job offer still remained for Jean. At that time, JCF had 26 hospital beds and 10 beds in the geriatric long-term care wing. The hospital performed minor surgeries with the help of a visiting operating team from Merced, there were routine baby deliveries, an occasional pediatrics case, an array of medical and cardiac patients that were treated, and a one bed emergency room.

Kiser’s 20 years of nursing experience was highly valuable as she quickly adjusted to her rural hospital nurse role in which she had to be an expert in all types of nursing care. And yet she recalls that her starting salary at JCF was just seven dollars per hour, quite a pay cut from her Southern California wages.

Around 1982 a contract with Riggs ambulance service out of Merced was obtained for Mariposa County that alleviated the burden on the JCF hospital nurses of having to ride along on the ambulance runs. However, the nurses still handled all of the medical dispatch calls at the nurse’s station by coordinating the ambulance service with directions to the call site and contacting the on-call physician.

In 1985, the registered nurses at JCF were encouraged to receive training and certification as Mobile Intensive Care Nurses (MICN) and Kiser was a member of that first class of nurses receiving this advanced training. The MICNs could issue prescribed orders over the hospital dispatch radio per protocols to paramedics who were now treating patients in the ambulance. The MICN certification of nurses allowed patients to receive advanced medical care en route to JCF Hospital. The newly formed JCF Employee Association in 1987 nominated Kiser as their first Employee of the Month.

Throughout the 1990s and into the new century, JCF remodeled and managed to survive the many financial crises facing the small district hospital. Along with the other staff members at JCF, Kiser always felt that they were providing an invaluable service to the local community by keeping the hospital open and running. Plenty of folks in the community felt likewise. Some services such as labor and delivery and the visiting surgical teams were phased out as costs escalated. The emergency room was eventually remodeled to become its own four bed unit complete with a separate staff of nurses and an in-house physician on-duty around the clock.

Jean has functioned in many roles at JCF including as infection control nurse, interim director of nurses, and even as the acting hospital administrator for a day or two when the CEO was out of town. For the past several years she has worked on a part-time basis covering two 12-hour shifts per week on the medical surgical side of the hospital.

“I still enjoy nursing and the friendships that I have gained with my colleagues over the many years of my career,” she said. “Nursing, for me, has been a true calling and I have never found another career that I thought would satisfy me quite as well.”

When asked how she might summarize her time at John C. Fremont Hospital over the past 30 years, Kiser has this to offer, “Some people may think that the level of care that they receive at a rural hospital may be substandard to that of a big city hospital. Our hospital staff members come to Mariposa from much bigger institutions, many with advanced training in their fields, and are very confident individuals that can adapt to a wide range of medical situations and patients. At larger urban hospitals there is a heavy emphasis on specialization in a particular field. The staff at JCF is incredibly versatile and cross-trained in their education out of necessity to deal with the unique situation of a rural hospital.”

One can easily conclude that with 50 years of nursing experience, Jean Kiser, RN, is an excellent example of the very unique individual qualities that make Mariposa a special place.